Combined Mitral and Tricuspid Valve Repair in Rheumatic Valve Disease

Abstract

Background-We examined predictors of early and very long-term outcome after combined mitral and tricuspid valve repair for rheumatic disease. Methods and Results-Between

Comparison of outcomes of tricuspid annuloplasty with 3D-rigid versus flexible prosthetic ring for functional tricuspid regurgitation secondary to rheumatic mitral valve disease

“…Suture annuloplasty, such as the Kay method (7) and the De Vega method (8), are routinely used for tricuspid valve repair by bicuspidization or reduce annular size semicircularly. It has the advantages of technically easy and low patient's economic burden, however associated with relatively high recurrent TR rate (9,10). Ring annuloplasty can reduce or remodel the dilated annulus by using prosthetic rings (flexible or rigid).…”

Prevalence, Predictors and Clinical Outcome of Residual Pulmonary Hypertension Following Tricuspid Annuloplasty

“…In order to reduce TR and improve clinical outcome, interest in tricuspid annuloplasty (TA) during left heart valve surgery has increased in recent years3, 4, 5 and the number of tricuspid procedures has doubled during the past decade 6. Although TA has shown a satisfactory perioperative and 30‐day result, 10‐year survival is limited to 50% to 74% 7, 8, 9, 10, 11. It is thus important to understand the mechanism that contributes to the high events rate in order to improve the postoperative clinical outcome in these patients.…”

Minimized Cardiopulmonary Bypass

“…Isolated tricuspid rheumatic valve disease is infrequent; due to this, clinical results of isolated tricuspid valve disease when appears with normal functioning left side valves are not known in detail (35). This is due to the scarce information available opposite to tricuspid regurgitation later after left side valve repair or replacement, which entails a high risk and very bad prognosis (36).…”

“…4 (5)(6)(7)(8). In the specific case of rheumatic valve disease it is clear that survival is better and reoperation less frequently required when the valve is repaired (9,10). On the other hand, the mechanisms of TV normal and abnormal function are well known for decades (11) and what is clear is that right ventricular contractility is a key component of TV function and that left-sided lesions do influence on TV function as well.…”

“…The contribution by Navia et al on the comparisons of techniques that include any type of support or the lack of it is of importance as defines success as related to the valve component influencing on the lesion (23). What seems clear is that TV ring annuloplasty tends to confer stability to the repair that positively influences long-term outcomes (10,28). Furthermore, there is a trend towards a reduced number or reoperations.…”